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The vein has to meet size requirement w. Steep trendelberg,,, why stand them if the you cannot do the ablation,, with a vein that is too small,, unless you have to pull it or inject it???

Denise Levy
408 391 0837
RVT, RDMS
TCD
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On Feb 7, 2011 11:45 AM, "Schneider, Joseph R." <[log in to unmask]> wrote:
> Many insurers (including BC/BS Illinois) now refuse to consider approving treatment unless it is explicitly stated that the exam is performed in the standing position
>
>
> From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Benge, Claudia
> Sent: Monday, February 07, 2011 12:32 PM
> To: [log in to unmask]
> Subject: Re: Venous Reflux and ICAVL requirements
>
> Susan,
> We use a 40 degree reverse trendelenburg position. We have 15 degree tilting beds with hydraulic head mechanisms. So we put two pillows for comfort behind their head and then raise the head of the bed. We have measured the angle and we get between 40 and 45 degrees by this maneuver. Then if we have trouble with recording reflux, our protocol calls for standing the patient and re checking the superficial veins that do not demonstrate either good flow or reflux. If no reflux found standing...then they do not have reflux. We have inexpensive steno chairs that allow us to sit low or higher.
> Watch out for patients that are more symptomatic at the end of their work day. We bring these type of patients in late in our scanning days so we can duplicate more of their symptoms. Also we ask them to drink water for about two hours prior so they will have better fluid hydration and increase in their flow hemodynamics.
> Claudia
>
>
> From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Case, Susan
> Sent: Monday, February 07, 2011 12:46 PM
> To: [log in to unmask]
> Subject: Venous Reflux and ICAVL requirements
>
> I am trying to find our how people are doing venous reflux exams these days. The ICAVL mandates that patients must be sitting or standing to perform the studies. Does anyone have any suggestions that do not necessitate purchasing new equipment?
>
> Susan Case RDMS/RVT
> Noninvasive Vascular Lab
> Summa Health System
>
>
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